Nyclobate NN Cream 20gm

Indications

Nyclobate NN is recommended for:

• Short-term management of stubborn eczemas.
• Neurodermatoses.
• Psoriasis (excluding extensive plaque psoriasis) when there is a suspected, likely, or confirmed secondary bacterial or fungal infection.
• Other inflammatory skin conditions that do not respond adequately to milder steroids.

Use only as directed by a registered healthcare professional.

Pharmacology

Clobetasol Propionate is an exceptionally potent corticosteroid used to address severe inflammatory skin conditions, including eczema and psoriasis, especially in cases where less potent corticosteroids have proven ineffective. Neomycin Sulphate, an aminoglycoside antibiotic, effectively combats bacterial infections, while Nystatin functions as an antifungal agent that disrupts the cell membranes of fungi and yeasts.

The precise mechanism of action of topical corticosteroids like Clobetasol is not entirely understood. Nevertheless, Clobetasol Propionate exhibits strong anti-inflammatory properties. Its primary action on the skin includes inducing a nonspecific anti-inflammatory response, partly through vasoconstriction and a reduction in collagen synthesis. Neomycin inhibits protein synthesis by binding to the ribosomal 30S and 50S sub-units of susceptible bacteria, also causing misreading of the mRNA genetic code, resulting in incorrect amino acids being incorporated into polypeptide chains. Nystatin binds to sterols in the fungal cell membrane, altering its permeability and causing leakage of intracellular components.

Dosage & Administration

Adults: Apply a small amount to the affected area once or twice daily until improvement is observed. For particularly resistant lesions, especially those with hyperkeratosis, the anti-inflammatory effect can be enhanced by occluding the treated area with polythene. Do not use for more than 7 days without medical supervision. If extended treatment is necessary, do not exceed 4 weeks without re-evaluating the patient’s condition.

Elderly: This formulation is suitable for elderly patients. Exercise caution in individuals with decreased renal function, as significant systemic absorption of Neomycin Sulphate may occur.

Children: This product is safe for children aged 2 years and older, with dosages similar to those for adults. There is a potential for increased absorption in younger children, so it is not recommended for use in neonates and infants under 2 years of age.

Use only as directed by a registered healthcare professional.

Interactions

Neomycin Sulphate may amplify and prolong the respiratory depressant effects of neuromuscular blocking agents following significant systemic absorption. However, if used according to the guidelines, systemic exposure to Neomycin Sulphate is minimal, making significant drug interactions unlikely. No hazardous interactions have been documented with Clobetasol Propionate or Nystatin.

Contraindications

This medication should not be used in patients with rosacea, acne vulgaris, perioral dermatitis, primary cutaneous viral infections (e.g., herpes simplex, chickenpox), or hypersensitivity to the components.

Side Effects

As with other topical corticosteroids, extended use of large quantities or treatment over extensive areas may lead to sufficient systemic absorption, causing symptoms of hypercortisolism. This effect is particularly likely in infants and children and may occur when occlusive dressings are applied. Prolonged use of highly potent corticosteroids can result in local skin changes such as thinning, striae, and dilation of superficial blood vessels, especially when occlusive dressings are employed or in skin folds. Reports of pigmentation changes and hypertrichosis have been associated with topical steroid use.

Pregnancy & Lactation

Limited information is available regarding the effects of topically applied Neomycin during pregnancy and lactation. However, Neomycin can cross the placenta and potentially pose a theoretical risk of fetal toxicity, so its use is not advised in pregnant or breastfeeding women. The safety of Clobetasol Propionate during lactation has not been established.

Precautions & Warnings

Long-term continuous topical therapy should be avoided whenever possible, particularly in infants and children, as adrenal suppression can occur even without occlusion. Care should be taken to prevent the medication from entering the eyes, as it may lead to glaucoma. If the product does come into contact with the eye, rinse thoroughly with plenty of water.

Overdose Effects

Acute overdosage is highly unlikely. No overdose-related issues have been reported. However, in cases of chronic overdosage or misuse, signs of hypercortisolism may emerge, necessitating a gradual discontinuation of topical steroids.

Therapeutic Class

Clobetasol / Clobetasone & Combined Preparations

Storage Conditions

Store below 25°C. Do not freeze. Keep out of the reach of children.